From the Department of Obstetrics/Gynecology, the Center for Clinical Epidemiology and Biostatistics, and the Center for Research in Reproduction and Women's Health, School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; and the Division of Biostatistics, Department of Medicine, Indiana University, Indianapolis, Indiana.
Obstet Gynecol. 2011 May;117(5):1095-1104. doi: 10.1097/AOG.0b013e318214f0de.
To estimate the duration of moderate-to-severe menopausal hot flushes and identify potential risk factors for hot flush duration.
The Penn Ovarian Aging Study cohort was monitored for 13 years. Hot flushes were evaluated at 9-month to 12-month intervals through in-person interviews. The primary outcome was the duration of moderate-to-severe hot flushes estimated by survival analysis (n=259). Potential risk factors included menopausal stage, age, race, reproductive hormone levels, body mass index (BMI), and current smoking. A secondary analysis included women who reported any hot flushes (n=349).
The median duration of moderate-to-severe hot flushes was 10.2 years and was strongly associated with menopausal stage at onset. Hot flushes that started near entry into the menopause transition had a median duration greater than 11.57 years; onset in the early transition stage had a median duration of 7.35 years (95% confidence interval [CI] 4.94-8.89; P<.001); and onset in the late transition to postmenopausal stages had a median duration of 3.84 years (95% CI 1.77-5.52; P<.001). The most common ages at onset of moderate-to-severe hot flushes were 45-49 years (median duration, 8.1 years; 95% CI 5.12-9.28). African American women had a longer duration of hot flushes than white women in adjusted analysis.
The median duration of hot flushes considerably exceeded the timeframe that is generally accepted in clinical practice. The identified risk factors, particularly menopausal stage, race, and BMI, are important to consider in individualizing treatment and evaluating the risk-to-benefit ratio of hormones and other therapies.
评估中重度绝经相关潮热的持续时间，并确定潮热持续时间的潜在风险因素。
宾夕法尼亚绝经衰老研究队列进行了 13 年的监测。通过面对面访谈，每 9-12 个月评估一次潮热。主要结局是通过生存分析评估中重度潮热的持续时间（n=259）。潜在的风险因素包括绝经阶段、年龄、种族、生殖激素水平、体重指数（BMI）和当前吸烟状况。二次分析包括报告有任何潮热的女性（n=349）。
中重度潮热的中位数持续时间为 10.2 年，与起始时的绝经阶段密切相关。在绝经过渡接近开始时出现的潮热中位数持续时间超过 11.57 年；在早期过渡阶段开始的中位持续时间为 7.35 年（95%置信区间 [CI] 4.94-8.89；P<.001）；在晚期过渡到绝经后阶段开始的中位持续时间为 3.84 年（95% CI 1.77-5.52；P<.001）。中重度潮热最常见的起始年龄为 45-49 岁（中位数持续时间 8.1 年；95% CI 5.12-9.28）。在调整分析中，非裔美国女性的潮热持续时间长于白人女性。
潮热的中位数持续时间大大超过了临床上普遍接受的时间框架。确定的风险因素，特别是绝经阶段、种族和 BMI，在个体化治疗和评估激素和其他疗法的风险-效益比方面非常重要。
